Doctor’s Tip: Big Pharma needs fixing

Following the discovery of antibiotics 90 years ago, the medical field became pill- and procedure-oriented. Initially, the business of medicine was altruistic. For example, in 1955 Jonas Salk developed the polio vaccine, which saved millions of lives and prevented millions of cases of disabling paralysis worldwide. When Dr. Salk was asked who owned the patent, his reply was: “Well, the people, I would say. There is no patent. Could you patent the sun?”

In the last twenty-five years, American medicine (hospitals, the pharmaceutical/medical device industry, medical insurance companies, physician specialty societies) has become big business — all about making profits rather than about what’s best for the citizens of this country. Following are some reasons it has become easy — in this environment of greed — to dislike the pharmaceutical industry:

• They have too much influence on Congress, through campaign contributions and lobbying — for example convincing them to make importing cheaper drugs from Canada illegal, convincing them to forbid Medicare from negotiating for better drug prices for seniors.

• They have too much influence on medical education and on practicing physicians: Drug reps develop cozy relationships with doctors in their offices and convince them to use their products, even though better and cheaper alternatives often exist. Medical journals contain drug ads. Most speakers at medical conferences have ties to pharmaceutical companies (which they now have to disclose).

• Pharmaceutical companies charge as much as they can get away with — especially for products that are critical for people with diseases such as M.S.

• When patents on brand-name products are about to expire, drug companies make minor changes and sell these “new” products at brand-name prices. Or they pay potential generic competitors to delay making lower-priced products.

• Although game-changing drugs have been developed over the years, most new drugs are “me too” drugs, that offer nothing new — a practice that isn’t allowed in most other developed countries. For example, losartan came out as an ARB drug for hypertension many years ago, but there are now several of these ARB drugs with no real advantage over the original losartan.

• They market directly to consumers — a practice that is only allowed in the U.S. and New Zealand.

• They justify over-charging for their products by saying that research and development is expensive — but they pay their CEOs inflated salaries and spend more on marketing than on R and D.

Can you imagine the altruism that Dr. Salk displayed in 1955 happening today? Now we have Goldman Sachs analysts warning biotech firms to stay away from drugs that offer “one shot cures.” They are referring to a new drug that cures hepatitis C, which “has gradually exhausted the available pool of patients.” The analysts suggest sticking to cancer drugs, “where the potential for a cure poses less risk to the sustainability of a franchise.” Drug companies benefit most from chronic diseases such as diabetes and hypertension, which — unless patients with these diseases make dramatic lifestyle changes — require medications for years. (As noted in previous columns, the U.S. doesn’t have a health care system, but rather a disease management system — we wait until diseases occur and then spend trillions trying to manage them. Big Pharma loves this dysfunctional system).

The PNHP (Physicians for a National Health Plan) developed the following principles for fixing the pharmaceutical industry:

• “Access to medications should be determined by medical need, not financial means.”

• “Drugs must be affordable to society.”

• “Drug development should be geared toward real innovation that maximizes population health.”

• “The human right to health must take precedence over intellectual property rights (patents).”

• “The safety and effectiveness of medications must be independently and rigorously evaluated.” (This refers to the pharmaceutical industry having undue influence on the FDA).

• “Comprehensive and unbiased information on drugs should be available to prescribers and patients.”

Dr. Feinsinger, who retired from Glenwood Medical Associates after 42 years as a family physician, has a nonprofit Center For Prevention and Treatment of Disease Through Nutrition. He is available for free consultations about heart attack prevention and other medical issues. Call 970-379-5718 for an appointment. For questions about his columns, email him at gfeinsinger@comcast.net.